Oliver Sacks' Musicophilia.

The Music Man

What neuroscience can't tell us about music.

The man in the photograph has a piece of electronic gear clamped to his head. He is bald, bearded, wearing wire-rimmed glasses. His eyes are closed, his mouth open. With one hand he holds the equipment in place: two big leathery pads smothering his ears, joined by a strap that holds them in place like a vise, running overhead across the place where the brain is.

The man is Oliver Sacks—on the cover of his new book, Musicophilia—and he is, presumably, listening to music. But if we didn't know better—if headphones were not our age's replacement for the fedora and the pillbox hat—it would be possible to mistake them for some brain-measuring neurological device.

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This conceit fits Sacks' approach. The headphones are akin to the stethoscope. The doctor is taking his own vital signs; and in Musicophilia, the mismatch between the barebones figures in Sacks' "tales of music and the brain" and the richness of his own response to music suggests that, in the tussle between the hard science of neurology and the soft science of belles-lettres—between nature and culture—culture still has plenty to say.

In an era when music has become "head music," delivered through iPod earbuds with the steady efficiency of an IV drip, it was inevitable that music, like language, religion, sex, and politics, would be given the popular-neuroscience treatment—and so it was in Daniel Levitin's 2006 best seller This Is Your Brain on Music.But as that book suggested,and Sacks' book now confirms, music has a way of eluding the neuroscientists' tools and schemas. For now at least, it is better understood the old-school culturo-critical way, through the tools of memory, imagination, passion, and cultivated taste.

Signs of Sacks' musicophilia—an outsized passion for music—were manifest early on. The son of a London doctor who owned an 1894 Bechstein grand piano and always had a set of miniature orchestral scores in his pocket, the young Sacks read The Oxford Companion to Music as if it were The Arabian Nights, "an inexhaustible source of musical stories." The leitmotif in his new book is the habit of referring back to musical episodes in his previous books, and it is Sacks himself who is his own most interesting patient when it comes to musical symptoms.

His retelling of the "complex musico-motor events" described in A Leg To Stand On points us to the core of his enterprise: a fascination with music as a cluster of patterns and imagery as unfathomably complex as the human brain, and as vital as life itself. Sacks wrenched his leg while mountain-climbing and managed to get down the mountain before nightfall by singing "The Old Volga Boatman"; he found himself "musicked along" as its rhythms and melodies made his mind forget pain. In the hospital, he listened to a cassette of a Mendelssohn violin concerto over and over again. Then, after weeks of struggling to walk, he stood and found that "the concerto started to play itself with intense vividness in my mind. In this moment, the natural rhythm and melody of walking came back to me, … and along with this [came] the feeling of my leg as alive, as part of me once again."

Sacks pursues new variations on the theme with his signature narrative blend of particular cases and neurological lore, at once creepy and cocktail-party colorful. We learn, for example, that the malady known as "fear of music" was first diagnosed in a 19th-century music critic who had a seizure at the opera and wound up running for cover in terror whenever he heard a brass band in the street. Famous people from Vladimir Nabokov to Ulysses S. Grant to the James brothers, Sacks tells us, seem to have suffered from "amusia"—the almost total inability to respond to music.

The material has the distinctive Sacks touch: at once earnest, tender, and slightly amused. But the anecdotes about music and the neurological disorders associated with it—which are what the "tales" really amount to—reveal surprisingly little about music or about the brain, other than that the mystery and vitality of music are useful correlatives to the brain's mystery and vitality. In recounting the circumstances of individual patients, Sacks doesn't evoke the sound of music or the ways sound takes shape as music in the brain. The case studies become examples of the gap between what happens in our brains and what even our most literate experts can say about it.

Yet the charmed circle of oddly afflicted music lovers whom Sacks has gathered around him help him explain and evoke music far more vividly than the scientific literature can. Scattered through the book, they come to seem a merry band of musicophiles who are keeping classical music alive through their passion for it. They are 60 or older. They have pianos in their apartments. They seem to play or listen to music every spare minute. They habitually, and vividly, express their extramusical experiences—of happiness and sadness, sickness and health—in musical terms, as in the case of a composer who was in a car crash and later found that her perfect pitch had disappeared.

The leader of the band is Sacks himself. Here he is describing a bout of amusia in 1974: "I was driving along the Bronx River Parkway, listening to a Chopin ballade on the radio, when a strange alteration of the music occurred. The beautiful piano tones started to lose their pitch and their character and were reduced, within a couple of minutes, to a sort of toneless banging with an unpleasant metallic reverberation, as if the ballade were being played with a hammer on sheet metal." It may be that this sudden cacophony is a musical disorder—but in the telling, it seems an instance of Sacks, in the car on the highway, instinctively using his response to music as a measure of a fugitive inner state.

A man making his own experiences and those of the people he knows the representatives of the human condition: It sounds like a formula for bad science. And yet the formula for bad science turns out to be the formula for good writing. When he describes his friends, and himself, too, Sacks suddenly writes about music as music, at once a language and a mode of celebration that summons extreme but not unreasonable passions.

Take the story of Leon Fleisher, the concert pianist—the nearest thing to a fully told "tale" in the book. A child prodigy, Fleisher was renowned as a pianist when, "at the age of thirty-six, he found the fourth and fifth fingers of his right hand starting to curl under his hand when he played. … [T]he more he fought, the worse the spasm became." He gave up performing and a doctor diagnosed his problem as "dystonia." Fleisher fell into despair, then pulled himself up by playing works written for one hand. Medicine advanced, and he found treatments for the spastic muscles. Thirty years after he was first stricken, control of the hand returned—and he returned to the stage.

In the meantime, Fleisher and Sacks had become friends, and Sacks concludes the tale with an account of the pianist's visit to the doctor's apartment—and the old Bechstein. "Fleisher sat at the piano and carefully, tenderly, stretched each finger in turn, and then, with arms and hands almost flat, he started to play. He played a piano transcription of Bach's 'Sheep May Safely Graze,' as arranged for piano by Egon Petri. Never in its 112 years, I thought, had this piano been played by such a master. … [H]e had matched his playing to the instrument, to bring out its greatest potential, its particularity."

Is this a tale of music and the brain, of science and a human obsession? In some sense, yes. But in another sense, it is a tale that would not be out of place in the Oxford Companion to Music that Sacks read as a boy in London, or among the tales of Henry James if only James had not suffered from amusia. It is the tale of a few moments in which an old chorale, an antique piano, a once-disabled hand, and a prodigy made wise by adversity called forth music together—in the presence of a listener with the ability to make sense of the experience. It is a tale, in other words, of how culture is made and passed from one person to another, from one era to the next. Sacks the scientist is not wholly absent, but Sacks the musicophile is wholly present and finds words for music and its effects that elude him elsewhere. And he seems to know it: "Fleisher seemed to distill the beauty, drop by drop, like an alchemist, into flowing notes of almost unbearable beauty—and, after this, there was nothing more to be said."

Paul Elie, the author of The Life You Save May Be Your Own (2003), is writing a book about the music of Bach.